Hip Replacement May Also Ease Back Pain

By Serena McNiff

HealthDay Reporter

THURSDAY, July 9, 2020 (HealthDay News) – If your hip and lower back hurt, a new study suggests that hip replacement surgery can solve both problems at once.

Researchers at the Hospital for Special Surgery in New York focused on 500 patients who underwent hip replacement surgery and followed up with them a year after the operation.

Over 40% reported pain in the lower back before hip surgery. Of this group, 82% saw their back pain go away after surgery.

He was “completely gone,” said study author Dr Jonathan Vigdorchik, a hip and knee surgeon at the hospital.

He said experts in his field have studied the connection between the hip and the back for years.

A hip replacement is surgery to replace a worn or damaged hip joint with an artificial joint. On average, it is a very successful operation, with 95% of patients experiencing pain relief, according to the Hospital for Special Surgery.

“It’s an exceptional procedure,” said Dr. Craig Della Valle, professor of orthopedic surgery at Rush University Medical Center in Chicago. “There are very few things in medicine that are close to hip replacement in terms of the quality of a medical procedure.” He was not part of the study.

But Vigdorchik added that patients who have undergone certain types of spine surgery before hip replacement surgery face five times the complication rate compared to the general population – for which the complication rate is less than 1 %.

This knowledge prompted him to delve deeper into hip-back interaction.

“We have noticed that there are certain conditions in which a hip condition can actually put undue stress on the back,” said Vigdorchik.

He and his fellow researchers wanted to find out just how effective a hip replacement can be in eliminating low back pain and which patients are most likely to benefit from it.

Patients whose low back pain resolved after surgery were those with “flexible spines,” according to Vigdorchik. When a person’s spine is flexible, a stiff or poorly functioning hip can cause the spine to move more than usual, causing pain.

Continued

Those with normal spinal flexibility were also very likely to have their pain resolved.

“These are the patients whose back pain disappeared completely after their hip replacement surgery, because their back pain was probably due to the fact that their hip did not function properly at the start,” said Vigdorchik.

But the back pain in patients with stiff thorns did not go away. Patients with a stiff spine already have severe arthritis of the spine, and hip replacement is unlikely to relieve their pain.

But how do you know if your back pain can be resolved with a hip replacement?

According to Vigdorchik, it is not easy to understand this for yourself. “It really depends on a good physical exam and then good x-rays,” he said.

Before a patient has hip replacement surgery, surgeons usually take an x-ray of the patient lying down.

In this study, the researchers took x-rays of their standing and seated patients, both before and after surgery.

These x-rays allowed them to see how the hip and spine moved in relation to each other, and assessed the flexibility of their spine, as the patient moved from a standing position to a sitting position. .

Vigdorchik encouraged other surgeons to use these x-rays to identify patients whose back pain could be relieved by hip replacement surgery.

He also advised surgeons in the field to “look beyond the hip”.

“Whenever they look at the hip, they should also look back, and whenever they look at the knee, they should look at the hip as well,” said Vigdorchik.

The existence of an interaction between the hip and the back is well known to experts, but Della Valle said this study shows how consistent it is.

He said the study gives surgeons in the field “a few tools to try to predict which patients you can say,” Yeah, your back pain will improve, “and others, well, maybe not.”

The study was recently published online at a virtual meeting of the American Academy of Orthopedic Surgeons.

HealthDay WebMD News

Sources

SOURCES: Jonathan Vigdorchik, MD, orthopedic surgeon, hip and knee replacement surgery, Hospital for Special Surgery, New York City; Craig Della Valle, MD, professor, orthopedic surgery, Rush University Medical Center, Chicago; AAOS 2020 Virtual Education Experience, March 26, 2020, online



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